If you were to compile a list of the world’s common phobias, dentophobia, or fear of the dentist, would no doubt be near the top. Dental phobias affect between 5 to 8 percent of all dental patients and are much more difficult to manage than the less intense, more generalized dental anxiety that about one-fifth of us experience.
Whereas dental anxiety would make a patient hesitate to visit the dentist, a dental phobia would make a patient avoid it at almost any cost — sometimes even if that means delaying necessary, urgent, or emergency dental treatment. Given the vital role oral health plays in overall health, conquering dental phobias is one of the top goals of dental professionals.
Dental phobia symptoms
Dental phobia symptoms are consistent with those of other phobias and may include sweating, muscle tension, a racing or palpable heartbeat, and low blood pressure potentially leading to fainting. It’s a physiological response that begins in the brain’s limbic system, which is heavily involved in the activation of our endocrine (hormone-producing) system and, in turn, our body’s fight-or-flight response.
The brain’s hippocampus and prefrontal cortex, which govern memory and logical thought, ordinarily help us rein in our fears. However, those suffering from a phobia may not be able to control their response so easily, if at all. Dental professionals must exercise care and understanding with these patients, with the realization that their extreme fear may very well have a physiological basis.
Dental phobia causes
Dental phobias can derive from external causes or be internally wired into our genes and personalities.
External causes of dental phobias
- Direct previous traumatic experiences, particularly during childhood
- Indirect vicarious experiences, or dental phobia “learned” from the traumas of others or from media (books, TV, movies, etc.)
Internal causes of dental phobias
- As suggested earlier, there may be a physiological basis for dental phobias — in particular a disconnect between the brain’s emotional and logical processing areas.
- Genetics — it is possible to inherit dental phobia
- Personality and personality disorders — one study revealed that extraversion and neuroticism significantly correlate with the incidence of dental anxiety
- Cognitive ability — individuals with developmental or intellectual disorders are less able/likely to express themselves verbally or emotionally, which elevates stress and tension.
Dental phobia treatments
Dental phobia treatments can take either a psychotherapeutic or a pharmacological approach. The most broadly accepted psychotherapeutic treatments attempt to rewire negative patterns of thought and behavior surrounding dental visits (cognitive-behavioral therapy); pharmacological approaches involve the administration of dental sedatives or anesthetics.
Psychotherapeutic treatments
Patients receive psychotherapeutic treatment for their dental phobias predominantly outside the dentist’s office — more likely working with a licensed therapist or counselor. These professionals may apply several therapies, which may include deep breathing and muscle relaxation techniques, desensitization or exposure therapy, biofeedback, hypnosis, or even acupuncture.
However, there are several things your dentist can (and should) do to help ease your mind — these include creating a pleasant office environment (e.g., through guided imagery and/or sound) and above all COMMUNICATION.
The notion of being powerless or not in control is at the root of dental anxiety and phobia. Techniques such as “tell-show-do” (calmly talking about and demonstrating each step in a procedure and then doing exactly that), modeling (observing an unafraid patient of a similar demographic receiving a similar treatment), and signaling (e.g. a raised hand to stop) give patients a sense of agency as they work through their fears.
Pharmacological treatments
Pharmacological treatments for dental phobias include any combination of medications that help suppress pain, induce a loss of consciousness or memory, and/or relax the mind and body. Sedation dentistry takes the approach of blurring the patient’s memory and response to pain along a continuum; sleep dentistry is synonymous with general dental anesthesia, wherein the patient is unconscious and involuntary functions like breathing are controlled by a certified anesthesiologist. Read our previous blog post to learn all the differences between sedation dentistry and sleep dentistry.
Conquer your fear of the dentist
At Sleep Dentistry with Dr. Kevin Mahoney, we are committed to helping our patients conquer their dental anxiety or dental phobia. We value transparency and communication with our patients and offer sleep dentistry as a means to get more crucial dental work done in less time, without fear or pain.